World TB Day

Today is World TB Day – a day set aside each year to draw attention to a disease that kills about two million people annually. In sub-Saharan Africa, the high prevalence of HIV/AIDS makes the battle against tuberculosis even tougher to win.

TB is a bacterial disease that can attack any part of the body, but usually hits the lungs the hardest. It’s spread through the air when a person infected with tuberculosis bacteria coughs or sneezes.

Marcos Espinal is executive secretary of the Stop TB Partnership.

"Two billion people, or one-third of the world population, carry the bacteria that develop TB as a disease. That’s to start with, infections. Nine million every year develop the disease, nine million new cases of tuberculosis worldwide of which two million die of the disease every year," he says.

The disease is concentrated in 22 countries, mainly in Africa and Southeast Asia.

"I can tell you the top five countries are China, India, Indonesia, Nigeria and Bangladesh," he says.

A UN report indicates TB cases are rising 3 to 4 percent a year across Africa.

The US Centers for Disease Control says not everyone who breathes in the bacteria develops TB. In fact, most people’s immune systems are able to fight the germs and keep them from growing. This is called latent TB and it may or may not develop into the disease later on.

But if the immune system is weak the bacteria can multiply. For example, the CDC says babies and young children have weak immune systems, as do people with HIV/AIDS.

"Oh, it’s a marriage. I call it marriage without divorce, basically. I can tell you the latest
report of the WHO released yesterday in London shows that the incidence of tuberculosis is declining in five of the six continents in the world, except in Africa due to the co-infection, joint infection of TB and HIV," he says.

He says in countries such as South Africa and Botswana, half of those infected with TB also have HIV, the top two killer diseases in the world. But Mr. Espinal says TB is also a disease of poverty.

"It’s a disease that affects those who don’t have access to food, to good living conditions, to medicines. And it has been a neglected disease for many years," he says.

Tuberculosis in the lungs has some obvious symptoms, including a bad cough lasting more than two weeks, coughing up blood or phlegm and chest pain. Other symptoms include weakness, chills, fever and weight loss. Those who have latent TB show no symptoms and do not spread the disease.

A simple skin test is done to detect tuberculosis and Mr. Espinal says treatment is available.

"Well, we have a very highly efficacious treatment. It’s called short course chemotherapy. It’s a combination of four drugs that the patient should take for six to nine months. It cures more than 85 percent of all those who take the drugs properly," he says.

The international strategy to fight the disease is called DOTS. It calls for government commitment, diagnosis, standard short-course therapy, a steady supply of quality drugs and the recording and reporting of all TB patients.

Several initiatives are underway to develop new drugs to cure TB more quickly, better diagnostic tools and a vaccine. The Global Alliance for Drug Development, based in New York, is leading the effort.

The Stop TB Partnership is a coalition of 300 institutions worldwide and hosted by th